DESCRIPTION (provided by applicant): The goal of the proposed study is to develop and test an adjunctive intervention (CLASP) to reduce suicide behavior and re-hospitalization in military veterans hospitalized for suicidal behavior. Suicide is one of the leading causes of death for military personnel and for the first time in recorded history the rates of military suicides are exceeding civilian rates. Despite the public and patient health costs associated with suicidal ideation and behavior, existing efforts have not appreciably reduced the rates of suicidal behavior in the military. Consequently, finding novel, efficacious, and acceptable methods to reduce suicide behaviors is of great military health relevance and should be a fundamental goal of clinical research with military veterans. The Coping Long Term with Active Suicide Program (CLASP) is an adjunctive intervention that combines aspects of problem-solving therapy, case-management, family support, and assessment. The program is a 6- month, adjunctive, telephone-based program designed for patients hospitalized for suicide behavior. CLASP includes, 3 individual sessions and one family session conducted while a patient is in the hospital, and a series of phone calls to both the patient and an identified significant other over the course of 6-months post- discharge. The program is designed to be easily integrated into the VA's current system, can be delivered by master's level clinicians, and will expand on, and compliment the role of the National Suicide Coordinator. The primary objective of this study is to test the efficacy of CLASP in a sample of veterans hospitalized for suicide behavior. Two hundred veterans will be randomly assigned to either the CLASP intervention or to a Safety Assessment and Follow-up Evaluation (SAFE) control condition. Both programs will be delivered as adjuncts to treatment as usual. Participants will be assessed at the end of the active intervention phase (3 and 6 months post-discharge from hospital) and again at 9 and 12 months post discharge. Efficacy of the program will be determined by several primary outcomes including number of attempts, number of re-hospitalizations, severity and chronicity of suicidal ideation. Secondary analyses will be conducted to help identify the types of patients who will receive the most benefit from the CLASP intervention.

Despite growing concern with increasing rates of suicidal behavior in OEF/OIF veterans, extant interventions have been unable to effectively reduce the suicide rate in veteran populations. The proposed study seeks to test the efficacy of an adjunctive intervention to reduce suicide behaviors in OEF/OIF veterans. The Coping Long Term with Active Suicide Program (CLASP) is an innovative, telephone-based intervention that combines elements of individual psychotherapy, case management and significant other/family therapy and is designed to be easily integrated into a VA system.